In recent years ‘shared care’ has been a popular topic in the Danish health services, especially in relation to chronic diseases. Shared care aims at creating coherent treatment of the patient through close collaboration and shared responsibilities across sectorial boundaries. In practice this vision is not always carried out. We have undertaken a comparative analysis of the circumstances for and the results of the implementation process of two database registration systems for diabetes patients; examples of ITsupported shared care. The system in Roskilde was developed using a bottom-up methodology, which implies that the development process was initiated on a small budget by the end users. In opposition to Roskilde, the system on Funen arose from a top-down development with financial support from the pharmaceutical industry. The two opposite development strategies have resulted in two functionally and structurally different systems. In spite of this the consequence of the implementation process in both counties is the same: the secondary sector has adopted the system but the primary sector is more sceptical towards using it. In this master thesis we are exploring the circumstances as to why it is so difficult to implement IT-supported shared care in the primary health sector. To examine this we primarily focus on three problem areas: • The two sectors are different in structure and culture, which has a big influence on their requirements and conditions. • The general practitioners are difficult to represent as a united group and therefore difficult to involve in the development process. Also the decision makers have no managerial power over the practitioners and therefore can’t make overall decisions for both sectors. A result of this has been that the focus of the development process was primarily on the secondary sector. • Maybe the treatment of diabetes is not suitable for IT-supported shared care. Diabetes only accounts for approx. 5 % of the consultations for a general practitioner. In our case study the general practitioners did not express any need for shared care in relation to diabetes treatment. This make the concept of shared care in relation to diabetes treatment seem irrelevant to general practitioners. The points mentioned above are some of the primary causes to why the process of implementing IT-supported shared care is so difficult.
|Uddannelser||Datalogi, (Bachelor/kandidatuddannelse) Bachelor el. kandidatKommunikation, (Bachelor/kandidatuddannelse) Bachelor el. kandidat|
|Udgivelsesdato||1 jun. 2006|
|Vejledere||Jesper Simonsen & Oluf Danielsen|
- sekundær sektor
- primær sektor
- shared care